Provider Demographics
NPI:1447551486
Name:MANGER, CATHERINE SAMSON (RPT)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:SAMSON
Last Name:MANGER
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:SALUTILLO
Other - Last Name:SAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPT
Mailing Address - Street 1:10724 MERE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7041 GRAND NATIONAL DRIVE
Practice Address - Street 2:SUITE 212
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:407-351-6330
Practice Address - Fax:407-351-6303
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT9400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist